Coding Inpatient Subject Matter Expert

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives?

Join us to start Caring. Connecting. Growing together.

The Coding inpatient subject matter expert (SME) will lead key initiatives within the organization related to quality metrics, workflow improvement, and audits to meet or exceed metrics, drive efficient coding services, and deliver excellence through standardization of processes and focus primarily on ensuring best practices are followed within their respective facilities. The Coding SME is a critical member of the Optum
360 HIM/Coding Operations team. This role is responsible for client facing meetings with the Quality Teams, CDI, and others directly related to accounts associated with prebill reviews, such as HAC/PSIs. The Coding SME drives continuous quality improvements and tracks, monitors, and trends to improve performance, business objectives and to disrupt the status quo to exceed Service Level Agreement commitments. This position must maintain solid client relationships and represent Optum
360 in all aspects of its values.

Primary Responsibilities:

* Maintains and demonstrates expert knowledge of coding, coding operations, coding review of all coding staff (domestic and global) and best demonstrated coding practices; drives the integration of Optum
360 Coding related business objectives within the client environment

* Identifies & builds consensus for facilitation of system and process standardization, utilization of best practices, work integration, change management, issue resolution, metric development and measurement, and communication related to the key components of coding operations.

* Leverages standard processes, systems, or other vehicles to reduce waste and cost at the facility while improving SLAs, KPIs (Key Performance Indicators), metrics and the overall client and/or patient experience

* Works collaboratively with HIM, CDI, Client, and Coding Operations to monitor day to day coding operations, complete prebill coding reviews, and prebill quality reviews

* Assists Coding Leadership with oversight of processes and initiatives designed to continuously improve coding quality and/or efficiency

* Maintains expert knowledge of coding to ensure high level of accuracy and proficiency standards of performance are achieved to meet or exceed targets

* Effectively leads and participates in coding quality assurance/compliance activities that include action plans relevant to audit results including remediation, education, and when appropriate assisting to create and monitor corrective action plans

* Serves as the liaison between the coding operations collaboratively bring each unit together including establishing, building, and maintaining cohesive relationships with the client

* Effectively utilizes tools and data provided to capture and continually improve union, client, and employee engagement. Leads initiatives towards meeting and exceeding employee satisfaction

* Leads by example; promotes teamwork by fostering a positive, transparent, and focused working environment which achieves maximum results

* Participates actively in leadership forums at the system level and leads such forums and other informational/educational offerings for assigned HIM/Coding/CDI Managers

* Other duties as needed and assigned by Optum
360 leadership, including but not limited to leading and conducting special projects. Develops project work plans, facilitates resource allocation, executes project tasks and obtains assistance from other intra and inter-departmental resources, as required

* Subject Matter Expert of applicable Federal, State, and local laws and regulations, Optum
360's organizational integrity program, standards of conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Promotes a service-oriented culture within the organization and assures satisfaction with the quality and amount of support provided for departmental functions, initiatives, and projects

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

* AAPC or AHIMA (CCS, CPC, RHIT or RHIA) coding credential

* 5+ years of experience in hospital coding

* Experience with computer assisted coding technologies and Epic coding workflow

* Experience working collaboratively with CDI and/or Quality leadership in partnership to improve reimbursement and coding accuracy

* Proficiency with:
Microsoft Excel (specifically…